脑出血患者血浆抵抗素浓度的检测及临床意义

Determination of Plasma Resistin Concentration in Patients with Hypertensive Intracerebral Hemorrhage and Its Clinical Significance

目的：揭示脑出血患者血浆抵抗素浓度的变化,探讨其在脑损伤中的作用及对预后的预测价值。方法：收集高血压性基底节区出血患者作为脑出血组,共123例。收集同期健康体检人群50例作为对照组。脑出血组静脉血在入院时获得。对照组静脉血体检时获得。ELISA检测血浆抵抗素（resistin）浓度。统计分析其与患者预后的相关性。结果：协方差分析显示,脑出血组血浆抵抗素浓度（27.1±10.2）ng/ml显著高于对照组（8.9±2.5）ng/ml（P〈0.01）。多因素分析显示,血浆抵抗素浓度与脑出血患者入院时GCS评分显著负相关（t=-5.107,P〈0.001）,是脑出血1个月内死亡的独立危险因素（OR=1.219,95%CI=1.065~1.537,P〈0.01）。ROC曲线分析显示,血浆抵抗素浓度预测脑出血1个月内死亡有显著预测价值（曲线下面积=0.819,95%CI=0.731~0.886,P〈0.001）,且判定血浆抵抗素浓度27.4ng/ml,对预测脑出血1个月内死亡有81.3%的灵敏度和76.9%的特异度。结论：脑出血后血浆抵抗素浓度升高,可能参与脑损伤的炎症反应,临床检测这个指标有助于早期判断脑出血患者的预后。

Objective In this study,change of plasma resistin level was determined in patients with hypertensive intracerebral hemorrhage and its correlation with outcome was evaluated.Methods 123 patients with spontaneous basal ganglia hemorrhage and 50 cases healthy controls were enrolled into this study.Plasma samples were obtained on entry in healthy controls,as well as on admission in the patients.The plasma resistin concentration was measured by enzyme-linked immunosorbent assay.Results The plasma resistin level（27.1±10.2 ng/ml） in patients was significantly higher than that（8.9±2.5 ng/ml） in healthy controls（P0.01）.A multivariate linear regression selected GCS score（t=-5.107,P0.001） related to plasma resistin level.On a multivariate logistic regression,plasma resistin level（odds ratio=1.219,95%C.I.=1.065~1.537,P0.01） was an independent variable predicting 1-month mortality.A receiver operating characteristic curve identified that the plasma resistin level27.4ng/ml predicted 1-month mortality of patients with 81.3% sensitivity and 76.9% specificity（AUC=0.819,95%CI=0.731~0.886,P0.001）.Conclusion Increased resistin level is found after intracerebral hemorrhage,in association with a poor clinical outcome.